Archibald Joseph Cronin was a Scottish physician and novelist. His best-known works are Hatter's Castle, The Stars Look Down, The Citadel, The Keys of the Kingdom and The Green Years, all of which were adapted to film. He also created the Dr...

, first published in 1937, which was groundbreaking with its treatment of the contentious theme of medical ethics

Medical ethics

Medical ethics is a system of moral principles that apply values and judgments to the practice of medicine. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology.-History:Historically,...

Great Britain or Britain is an island situated to the northwest of Continental Europe. It is the ninth largest island in the world, and the largest European island, as well as the largest of the British Isles...

The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...

The Stars Look Down is a 1935 novel by A. J. Cronin which chronicles various injustices in an English coal mining community. A film version was produced in 1939, and television adaptations include both Italian and British versions....

The goal of coal mining is to obtain coal from the ground. Coal is valued for its energy content, and since the 1880s has been widely used to generate electricity. Steel and cement industries use coal as a fuel for extraction of iron from iron ore and for cement production. In the United States,...

The South Wales Valleys are a number of industrialised valleys in South Wales, stretching from eastern Carmarthenshire in the west to western Monmouthshire in the east and from the Heads of the Valleys in the north to the lower-lying, pastoral country of the Vale of Glamorgan and the coastal plain...

Tredegar is a town situated on the Sirhowy River in the county borough of Blaenau Gwent, in south-east Wales. Located within the historic boundaries of Monmouthshire, it became an early centre of the Industrial Revolution in South Wales...

, where he had researched and published reports on the correlation between coal dust inhalation and lung disease. Additionally, he worked as a doctor for the Tredegar Medical Aid Society at the Cottage Hospital

Tredegar General Hospital

Tredegar General Hospital is a community hospital in Tredegar, Blaenau Gwent, Wales providing rehabilitation and GP in-patient care with 85 full and part-time staff and 58 beds in two wards. There is a small 24 hour minor casualty unit staffed by nurses. The hospital is operated by the Aneurin...

The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...

. Cronin once stated in an interview, "I have written in The Citadel all I feel about the medical profession, its injustices, its hide-bound unscientific stubbornness, its humbug ... The horrors and inequities detailed in the story I have personally witnessed. This is not an attack against individuals, but against a system." The novel was made into a 1938 film

The Citadel (film)

The Citadel is a 1938 film based on the novel of the same name by A. J. Cronin, first published in 1937. The film was directed by King Vidor and produced by Victor Saville.-Plot:...

Rosalind Russell was an American actress of stage and screen, perhaps best known for her role as a fast-talking newspaper reporter in the Howard Hawks screwball comedy His Girl Friday, as well as the role of Mame Dennis in the film Auntie Mame...

Sir Ralph David Richardson was an English actor, one of a group of theatrical knights of the mid-20th century who, though more closely associated with the stage, also appeared in several classic films....

The Citadel is a 1960 American television adaptation of A. J. Cronin's 1937 novel, The Citadel. It was written by Dale Wasserman and starred James Donald as Dr. Manson and Ann Blyth as Christine Barlow...

The Citadel is a 1960 British television adaptation of A. J. Cronin's 1937 novel, The Citadel. The series was directed by John Frankau and produced by Peter Graham Scott. It starred Eric Lander as Dr. Andrew Manson, and Zena Walker as Christine, his wife...

La Cittadella is a 1964 Italian miniseries based on A. J. Cronin's 1937 novel, The Citadel, and produced by Radiotelevisione Italiana. It was directed by Anton Giulio Majano and stars Alberto Lupo as Dr. Manson and Anna Maria Guarnieri as his wife, Christine...

La Cittadella is a 2003 Italian miniseries based on A. J. Cronin's 1937 novel, The Citadel, and produced by Titanus. It was directed by Fabrizio Costa and stars Massimo Ghini as Dr. Manson and Barbora Bobulová as his wife, Christine...

) adaptations of the novel. There are also three Indian film adaptations: Tere Mere Sapne

Tere Mere Sapne (1971 film)

Tere Mere Sapne is a 1971 film produced by Dev Anand, and written and directed by his brother Vijay Anand for Navketan Films. The movie stars Dev, Vijay, Mumtaz, and Hema Malini. The film's music is by S. D. Burman, and the story is based on The Citadel, a novel by A.J. Cronin...

Standard Hindi, or more precisely Modern Standard Hindi, also known as Manak Hindi , High Hindi, Nagari Hindi, and Literary Hindi, is a standardized and sanskritized register of the Hindustani language derived from the Khariboli dialect of Delhi...

Bengali or Bangla is an eastern Indo-Aryan language. It is native to the region of eastern South Asia known as Bengal, which comprises present day Bangladesh, the Indian state of West Bengal, and parts of the Indian states of Tripura and Assam. It is written with the Bengali script...

Telugu is a Central Dravidian language primarily spoken in the state of Andhra Pradesh, India, where it is an official language. It is also spoken in the neighbouring states of Chattisgarh, Karnataka, Maharashtra, Orissa and Tamil Nadu...

.

Plot summary

In October of 1921, Andrew Manson, an idealistic, newly qualified doctor, arrives from Scotland to work as assistant to Doctor Page in the small Welsh mining town of 'Drineffy'. He quickly realises that Page is an invalid and that he has to do all the work for a meagre wage. Shocked by the insanitary conditions he finds, he works to improve matters and receives the support of Dr Philip Denny, a cynical semi-alcoholic. Resigning, he obtains a post as assistant in a miners' medical aid scheme in 'Aberalaw', a neighbouring coal mining

Coal mining

The goal of coal mining is to obtain coal from the ground. Coal is valued for its energy content, and since the 1880s has been widely used to generate electricity. Steel and cement industries use coal as a fuel for extraction of iron from iron ore and for cement production. In the United States,...

Silicosis, also known as Potter's rot, is a form of occupational lung disease caused by inhalation of crystalline silica dust, and is marked by inflammation and scarring in forms of nodular lesions in the upper lobes of the lungs...

research. Eager to improve the lives of his patients, mainly coal miners, Manson dedicates many hours to research in his chosen field of lung disease. He studies for, and is granted, the MRCP

Membership of the Royal College of Physicians

Membership of the Royal Colleges of Physicians is a postgraduate medical diploma. The examinations are run by the Federation of the Medical Royal Colleges of the United Kingdom – the Royal College of Physicians of London, the Royal College of Physicians of Edinburgh, and the Royal College...

Doctor of Medicine is a doctoral degree for physicians. The degree is granted by medical schools...

. The research gains him a post with the 'Mines Fatigue Board' in London, but he resigns after six months to set up a private practice.

Seduced by the thought of easy money from wealthy clients rather than the principles he started out with, Manson becomes involved with pampered private patients and fashionable surgeons and drifts away from his wife. A patient dies because of a surgeon's ineptitude, and the incident causes Manson to abandon his practice and return to his former ways. He and his wife repair their damaged relationship, but Christine is killed in a traffic accident. It is Denny, now teetotal, who whisks him off to the Welsh countryside to recover.

Since Manson had accused the incompetent surgeon of murder, he is vindictively reported to the General Medical Council

General Medical Council

The General Medical Council registers and regulates doctors practising in the United Kingdom. It has the power to revoke or restrict a doctor's registration if it deems them unfit to practise...

Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...

specialist who does not have a medical degree, even though the patient had been successfully treated at his nature cure clinic.

Despite his lawyer's gloomy prognosis, Manson forcefully justifies his actions during the hearing and is not struck off the medical register.

He joins Denny and bacteriologist Dr Hope in opening an integrated, multispecialty practice, then uncommon, in a country town.